Eating Disorder Treatment

How to Know What Level of Eating Disorder Treatment You Need

Deciding what level of eating disorder treatment you—or someone you love—need can feel overwhelming. You might be wondering, “Is this serious enough?” or “Am I overreacting?”

The truth is, eating disorders don’t follow a clear line. And figuring out the right level of support isn’t always obvious.

In this guide, we’ll walk you through the different levels of eating disorder treatment—from outpatient therapy to inpatient care—so you can better understand your options and what might be the right next step.

And if you’re still unsure, you don’t have to figure it out alone. We’re here to help.If you’re still not sure which is right for you, please reach out to us so we can talk about it.

When determining the appropriate level of eating disorder treatment, providers consider much more than just weight.

Most treatment decisions take into account your physical health, emotional well-being, eating disorder behaviors, and the level of support you need day-to-day.

• Medical status
• Suicidality
• Weight (as a percentage of healthy body weight)
• Motivation to recover, including cooperativeness, insight, and ability to control obsessive thoughts
• Co-occurring disorders, including substance use, depression, and anxiety
• Structure is needed for eating and gaining weight
• Ability to control compulsive exercising

Below is a graphic that highlights the basics for each level, followed by a more in-depth look at the levels of eating disorder treatment and how the APA’s guidelines apply to each of them.

Level 1: Outpatient Eating Disorder Treatment

Outpatient eating disorder treatment typically includes individual sessions with a therapist and/or dietitian, typically once or twice a week. Outpatient treatment typically last for months to years, and can sometimes include periods of being in a higher level of care. Also, sometimes outpatient care can include group therapy. Outpatient eating disorder treatment is likely right for you if you:

• are medically stable
• have at least some motivation for recovery
• can implement some structure on your own regarding meals
• are able to at times limit your eating disorder behaviors, including compulsive exercise
• are not suicidal with a plan or intent to harm yourself

Level 2: Intensive Outpatient Program (IOP) for Eating Disorders

Intensive outpatient eating disorder treatment typically includes about three hours of programming for at least two to three days a week. At this level of care, you would live at home and could probably still work or go to school. Usually, one meal or snack takes place at the treatment center. IOP eating disorder treatment is likely right for you if you:

• are medically stable
• have at least some motivation for recovery
• can implement some structure on your own regarding meals but need a bit of support/accountability
• are able to at times limit your eating disorder behaviors, including compulsive exercise, but need a bit of support/accountability
• are not suicidal with a plan or intent to harm yourself

Level 3: Partial Hospitalization (PHP) for Eating Disorders

Partial hospitalization programs typically include treatment during most of the day, while letting you still go home at night. PHP is usually 6 to 11 hours a day for at least five days a week, so the majority of meals are at the treatment center. PHP eating disorder treatment is likely right for you if you:

• are medically stable
• have some motivation for recovery but are struggling to feel motivated at times
• need structure and support for most meals 
• struggle to limit your eating disorder behaviors, including compulsive exercise and need quite a bit of support/accountability
• are not suicidal with a plan or intent to harm yourself

Level 4: Residential Eating Disorder Treatment

Residential eating disorder treatment provides 24-hour care for those who are medically stable but still require round-the-clock supervision meals and behaviors. Residential treatment is typically 6 weeks or longer. This level of care is likely right for you if you are medically stable and have a/an:

• need for supervision to eat 
• need for supervision to not purge or use other behaviors
• inability to stop exercising
• lack of treatment options near home

Level 5: Inpatient Eating Disorder Treatment

Inpatient eating disorder treatment is 24-hour care in a medical hospital. This level is for individuals who are not medically stable and need round-the-clock medical assistance or monitoring (including intravenous fluids, tube feeds, and constant monitoring of vital signs). This is often a necessary level of care for individuals who do not cooperate with treatment protocols at lower levels of care. Inpatient stays can last days to weeks. This is likely the right level for you if you are not medically stable or if you have:

• unstable heart rate or blood pressure
• significant weight decline and/or food refusal
• evidence of malnutrition
• other psychiatric disorders that would require hospitalization
• suicidal thoughts with intent to harm yourself

A quick note in case you’re asking yourself Am I Really Sick Enough for Eating Disorder Treatment?…

I hear this question all the time. Sweet friend, the answer is always “YES!”

Your eating disorder will try to convince you that you don’t need or don’t deserve help. It will whisper lies about things not being that bad, about you being able to handle it, about not looking like you even have an eating disorder…

Don’t listen to any of that or any other excuse your ED gives you. Eating disorders don’t have a “look” despite the stereotype, and people at all weighs can have an ED. And you don’t have to be at the point of needing hospitalization to be “sick enough”. Please, please don’t wait for that point to get help.

You could miss out on spending years of your life with joy and purpose instead of spending them still consumed with your ED. You could do irreparable damage to your body, or yes, even die.

Don’t believe your eating disorder. You are worthy of help and support. Today. Not sometime in the future when things get worse. TODAY.

xo.

Final Thoughts…

Again, I know it might feel overwhelming trying to figure out the right eating disorder treatment for you (or your loved one). If you’re still not sure which is right or if you need a referral to higher level of care, please reach out to us, and we’ll be happy to help you figure that out.

If you want to learn more about eating disorder therapy at the outpatient treatment level with us, you can do that here.

Sources
https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/level-care-guidelines-patients